| Peritoneal cytokines predict mortality after surgical treatment of secondary peritonitis in the rat. | |
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MedLine Citation:
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PMID: 20670866 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The study aimed to analyze if peritoneal cytokine levels can predict survival in an experimental model for peritonitis. Early identification of patients most at risk for adverse outcomes would facilitate the decision for aggressive therapy in order to maximally exploit their chance for survival. STUDY DESIGN: Peritonitis was induced by intraperitoneal injection of a feces/bacteria mixture in 175 rats. Surgical debridement was performed after 1 hour. Abdominal fluid samples were taken after 24 and 72 hours for the measurement of interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-alpha. Surviving animals were sacrificed after 5 days and correlations between cytokine levels and survival were analyzed. RESULTS: Altogether, 60 animals died prematurely, 12 before the first sampling of cytokines. So, 48 nonsurvivors and 115 survivors were analyzed. Peritoneal cytokine levels were much higher (p < 0.0001) in nonsurvivors than in survivors. At 24 hours there were strong correlations between cytokine levels, especially between IL-6 and IL-10 (r = 0.93). Peritoneal cytokines at 24 hours also discriminated between animals dying within the next 24 hours and those dying later. A strongly (p < 0.0001) increased mortality was observed if IL-6, IL-10, or TNF-alpha levels exceeded 2, 1, or 0.2 ng/mL, respectively. Receiver operating characteristic curves were promising for all 3, but IL-10 showed the best characteristics, with an area under the curve of 0.94 and 67% sensitivity at 95% specificity, obtained at a cut-off value of 1.26 ng/mL. CONCLUSIONS: These data should generate renewed interest to examine the peritoneal cytokines as early markers for adverse outcomes in patients with secondary peritonitis. Possibly, combinations of peritoneal cytokines with other markers can lead to much needed, reliable early prediction of disease severity. |
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Authors:
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Thijs Hendriks; Robert P Bleichrodt; Roger M L M Lomme; Ben M De Man; Harry van Goor; Otmar R Buyne |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2010-06-26 |
Journal Detail:
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Title: Journal of the American College of Surgeons Volume: 211 ISSN: 1879-1190 ISO Abbreviation: J. Am. Coll. Surg. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-30 Completed Date: 2010-09-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9431305 Medline TA: J Am Coll Surg Country: United States |
Other Details:
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Languages: eng Pagination: 263-70 Citation Subset: AIM; IM |
Copyright Information:
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Copyright 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. T.Hendriks@chir.umcn.nl |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Ascitic Fluid / chemistry* Cytokines / metabolism* Disease Models, Animal Enzyme-Linked Immunosorbent Assay Interleukin-10 / metabolism Interleukin-6 / metabolism Laparotomy* Male Peritoneum / metabolism* Peritonitis / metabolism, mortality*, surgery Postoperative Period Predictive Value of Tests Prognosis Rats Rats, Wistar Sensitivity and Specificity Survival Rate / trends Tumor Necrosis Factor-alpha / metabolism |
| Chemical | |
Reg. No./Substance:
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0/Cytokines; 0/Interleukin-6; 0/Tumor Necrosis Factor-alpha; 130068-27-8/Interleukin-10 |
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